When patients assault staff

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I am curious on how other nurses and hospitals deal with patients who end up physically assaulting health care staff. My hospital is in an underserved community and we can have rough crowds, lots of homeless, lots of addiction, etc. I have read a lot about violence against nurses and was wondering what would be the appropriate action should a patient actually hit, punch, or hurt me. We do have an internal "code grey" which sends security staff to help assist, but I feel like if it ever got to the point of me getting hurt, it would be up to me to file a police report to take things to the next level. I feel like it is inappropriate to turn a blind eye to a nurse who got punched in the face or assaulted some other way. Has anyone ever done this and did you get any push back from the hospital or management for moving forward with a charge?

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Specializes in Psych (25 years), Medical (15 years).
8 minutes ago, CaliRN2019 said:

 did you get any push back from the hospital or management for moving forward with a charge?

In over twenty five years of working psych and having had many physical aggressions, there is but one time that I pressed charges against a patient.

I received no guff from administration, but nothing ever became of the charges, CaliRN.

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Specializes in Emergency Department.

Management should always back up their staff. No exceptions.

I worked in an ED in the UK and there was sometimes violence. We always prosecuted. Basically it works out as punch a nurse you go to jail for 3 months.

A few years back we asked for security and were told that as far as management were aware we did not have problem. Turns out because we were just handling it all ourselves in-house it was not getting reported. We did not have a huge problem but once we reported every time we got security. We were also given training in how to keep ourselves safe.

So document and report.

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25 minutes ago, CaliRN2019 said:

Has anyone ever done this and did you get any push back from the hospital or management for moving forward with a charge?

 

I would never worry about what the hospital thought about how I was going to handle something like this.

By the way, HIPAA has specific provisions regarding disclosing patient information if there is a reasonable belief that the patient has committed a crime on the covered entity's premises, or if a party affiliated with the covered entity (employer) has been the victim of a crime. So no worries there. Don't be threatened into silence by concerns over patient privacy or HIPAA.

I have seen all kinds of behavior from employers, from contacting the prosecutor themselves in order to advocate for a nurse's safety, to trying to downplay the issues, to outright lying about whether nurses are "allowed" to report crimes against themselves.

You are allowed to make police reports if you believe you have been the victim of a crime. You are allowed to cooperate with any subsequent investigations or prosecutions. If the employer feels like cooperating, that's great. Otherwise they get no say in the matter AFAIC.

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Specializes in Mental health, substance abuse, geriatrics, PCU.

Violence against healthcare providers is a topic I feel very passionate about. I don't think we should be treated as verbal or physical punching bags to our patients and their families, sadly it happens all too frequently. I think it is absolutely pivotal that nurses press charges against those who assault us. That being said, sometimes it does come at a cost. There is one facility where I live that is notorious for its exceptionally high rate of violence against staff, and it's also notorious for attempting to sweep the many assaults they have under the rug. I know of several people who were let go from the facility because they pressed charges on a violent patient, however, most facilities will not terminate you over this, most will either support you or they will try to discourage you and maybe even turn things around on you. My favorite response from management is "Well, what did you do that made him so angry?"

In my experience charges are not taken very seriously by law enforcement or the judicial system and every person I know that has ever filed charges wound up having them thrown out by the judge, particularly if the patient has any mental health issues even if they cognitively intact, I've been in a courtroom and heard the judge say "Well, you should expect for these things to happen."

Despite the powers that be minimizing violence towards us, unless we continue to do what right for ourselves, nothing will ever change.

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unfortunate

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Specializes in Mental Health.

I work in the mental health field where this is unfortunately common. I fortunately have never been assaulted, but I have witnessed it and am aware of staff who have made police reports. Honestly, I don’t think it does any good because the patients “aren’t in their right mind” supposedly. Sometimes that is true and sometimes it isn’t. Looking from an outsider’s perspective though, when a case comes across a desk and it’s “Jane Doe was inpatient at a psychiatric facility..” I think the people who review the case do show leniency because of the patient’s mental state. 

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Specializes in Mental health, substance abuse, geriatrics, PCU.
22 minutes ago, BSC_RN said:

I work in the mental health field where this is unfortunately common. I fortunately have never been assaulted, but I have witnessed it and am aware of staff who have made police reports. Honestly, I don’t think it does any good because the patients “aren’t in their right mind” supposedly. Sometimes that is true and sometimes it isn’t. Looking from an outsider’s perspective though, when a case comes across a desk and it’s “Jane Doe was inpatient at a psychiatric facility..” I think the people who review the case do show leniency because of the patient’s mental state. 

It really is a strange quirk of the legal system. When a healthcare provider is physically harmed, even if the patient was fully aware of what they were doing and that it was wrong the charges are often dismissed or reduced. Yet if the same person were to shoplift, or get charged with possession or some other crime then they get thrown in jail. Makes no sense to me and goes to show how expendable we seem to be.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

A couple years ago I was punched in the face by a detoxing patient in the unit. We were boosting him and fortunately for me he had mitts on, but he was still able to get me on the chin hard enough that it hurt for days. I was ready to pass it off as him being out of it- he was on precedex and ativan at the time, but then he continued to taunt me for the rest of the shift and ask how my chin felt. Then he tried to kick my tech in the head when she leaned in to empty his condom catheter. So I ended up calling the police. The officer that responded was beyond rude. He said he couldn't believe that a nurse that was responsible for providing care for critically patients would ever turn against them like that and maybe I shouldn't be doing my line of work if I couldn't handle some of the risks. In hindsight I should have contacted his superior officer and filed some sort of a complaint, but this shift occurred at the end of a particularly stressful run and I just wanted to get home and forget it all. The officer said he would file whatever, but the judge would throw it out because the patient clearly was medically incapacitated. This patient is a frequent flyer and he's known for being completely disrespectful to women and we've all been on the receiving end of lewd comments, snide remarks, he will urinate on staff when he has the chance, even when he's sober and off all meds he's just a jerk. The only reason I wanted to file it was that even if my complaint didn't go anywhere, if there was a record of it then maybe the next time he did it while he wasn't in critical care, there would be a pattern. 

Management and my hospital didn't do anything. 

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Specializes in Psych (25 years), Medical (15 years).
40 minutes ago, JBMmom said:

The officer that responded was beyond rude. He said he couldn't believe that a nurse that was responsible for providing care for critically patients would ever turn against them like that and maybe I shouldn't be doing my line of work if I couldn't handle some of the risks.

As a first responder at MVAs and such, the Police officers have consistently given me great respect.

However, in other situations, such as the time my Ex broke into my house and stole some things, the officer I was filing a complaint with came across as a know-it-all Judge, Jury, and Executioner. He came off as rude, rapid firing a bunch of pointless, rhetorical questions at me.

With me being something of an assertive arrogant, and ticked off anyway, I reminded him of his job, and that was to merely take information and follow through accordingly.

Sometimes we need to bully the bullies into submission.

With these oxen we must plow, eh, JBMmom?

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On 2/10/2021 at 8:04 PM, TheMoonisMyLantern said:

Violence against healthcare providers is a topic I feel very passionate about. I don't think we should be treated as verbal or physical punching bags to our patients and their families, sadly it happens all too frequently. I think it is absolutely pivotal that nurses press charges against those who assault us. That being said, sometimes it does come at a cost. There is one facility where I live that is notorious for its exceptionally high rate of violence against staff, and it's also notorious for attempting to sweep the many assaults they have under the rug. I know of several people who were let go from the facility because they pressed charges on a violent patient, however, most facilities will not terminate you over this, most will either support you or they will try to discourage you and maybe even turn things around on you. My favorite response from management is "Well, what did you do that made him so angry?"

In my experience charges are not taken very seriously by law enforcement or the judicial system and every person I know that has ever filed charges wound up having them thrown out by the judge, particularly if the patient has any mental health issues even if they cognitively intact, I've been in a courtroom and heard the judge say "Well, you should expect for these things to happen."

Despite the powers that be minimizing violence towards us, unless we continue to do what right for ourselves, nothing will ever change.

Everyone incl judges report to supervisors. Judges if asked in court openly and politely, if you were dissatisfied, could you appeal or write to an appropriate source for an opinion, quickly gets that you are serious and know that you won't be pushed around. You never mention social media in a court, but you can mention facebook groups. Judges like people have reputations to protect and you will be putting opposing councel on alert as well. 

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11 hours ago, BSC_RN said:

I work in the mental health field where this is unfortunately common. I fortunately have never been assaulted, but I have witnessed it and am aware of staff who have made police reports. Honestly, I don’t think it does any good because the patients “aren’t in their right mind” supposedly. Sometimes that is true and sometimes it isn’t. Looking from an outsider’s perspective though, when a case comes across a desk and it’s “Jane Doe was inpatient at a psychiatric facility..” I think the people who review the case do show leniency because of the patient’s mental state. 

I have mostly found that most violent patients are predictable through their behaviors. Charting is paramount as a reference source for later and as an identified potential problem. This is invaluable for court evidence if applicable. 

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